How frequent is absolute femoral retroversion in symptomatic patients with cam- and pincer-type femoroacetabular impingement?

Meier, Malin; Reche, Jelena; Schmaranzer, Florian; Tengg-Kobligk, Hendrik von; Steppacher, Simon D.; Tannast, Moritz; Novais, Eduardo N.; Lerch, Till

doi:10.1302/2633-1462.37.bjo-2022-0049.r1

Cited by 4 publications

(1 citation statement)

References 61 publications

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“…[ 17 ] define severely increased version as >35° with severe retroversion as <0°. Other literature has reported <5° as the threshold to define femoral retroversion [ 6 , 31 , 32 ], and >22° has also been reported as the threshold for femoral anteversion [ 33 ]. There is no clear consensus regarding the threshold for normal values.…”

Section: Discussionmentioning

confidence: 99%

Proximal femoral derotation osteotomy for management of femoral malversion: a systematic review

Sohatee,

Jaibaji,

Malviya

2023

Journal of Hip Preservation Surgery

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Femoral malversion is an under-recognized contributor to hip pain in younger adults. Under treatment is often a contributor to poor outcomes in hip preservation surgery. We reviewed the literature to analyse the outcomes of proximal femoral derotation osteotomy as a treatment for femoral malversion as well as propose our own management algorithm for treating such patients. A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines searching four databases (PubMed, CINALH, MEDLINE and EMBASE) for studies investigating the outcomes of derotation osteotomy in treating malversion. Nine studies were found encompassing 229 hips. At a mean follow-up of 39.9 months across the studies, there were only two conversions (1%) to total hip arthroplasty and four revision cases in total. Seven of the nine studies reported improved functional outcomes in their cohorts, with the mean Harris hip score improved from 63.7 to 87.3 where reported. There is a paucity of literature around the outcomes of proximal femoral derotation osteotomy. However, both the evidence available and the authors’ experience suggest that consideration of femoral malversion is an essential component of hip preservation surgery, improving functional outcomes in cases of excessive femoral anteversion and femoral retroversion.

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Section: Discussionmentioning

confidence: 99%

Proximal femoral derotation osteotomy for management of femoral malversion: a systematic review

Sohatee,

Jaibaji,

Malviya

2023

Journal of Hip Preservation Surgery

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Radiological predictors of outcomes in hip arthroscopy for femoroacetabular impingement

Wagner,

Schaller,

Endstrasser

et al. 2024

Bone Joint J

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AimsHip arthroscopy has gained prominence as a primary surgical intervention for symptomatic femoroacetabular impingement (FAI). This study aimed to identify radiological features, and their combinations, that predict the outcome of hip arthroscopy for FAI.MethodsA prognostic cross-sectional cohort study was conducted involving patients from a single centre who underwent hip arthroscopy between January 2013 and April 2021. Radiological metrics measured on conventional radiographs and magnetic resonance arthrography were systematically assessed. The study analyzed the relationship between these metrics and complication rates, revision rates, and patient-reported outcomes.ResultsOut of 810 identified hip arthroscopies, 359 hips were included in the study. Radiological risk factors associated with unsatisfactory outcomes after cam resection included a dysplastic posterior wall, Tönnis grade 2 or higher, and over-correction of the α angle. The presence of acetabular retroversion and dysplasia were also significant predictors for worse surgical outcomes. Notably, over-correction of both cam and pincer deformities resulted in poorer outcomes than under-correction.ConclusionWe recommend caution in performing hip arthroscopy in patients who have three positive acetabular retroversion signs. Acetabular dysplasia with a lateral centre-edge angle of less than 20° should not be treated with isolated hip arthroscopy. Acetabular rim-trimming should be avoided in patients with borderline dysplasia, and care should be taken to avoid over-correction of a cam deformity and/or pincer deformity.Cite this article: Bone Joint J 2024;106-B(8):775–782.

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Ischiofemoral Impingement Syndrome: Clinical and Imaging/Guidance Issues with Special Focus on Ultrasonography

Chang

Mezian

et al. 2022

Diagnostics

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Ischiofemoral impingement syndrome is a neglected cause of posterior hip pain which is derived from narrowing of the space between the lateral aspect of the ischium and the medial aspect of the lesser trochanter. Its diagnosis is challenging and requires the combination of physical tests and imaging studies. In the present narrative review, we found that femoral anteversion predisposes patients to the narrowing of the ischiofemoral space and subsequent quadratus femoris muscle injury. Magnetic resonance imaging serves as the gold-standard diagnostic tool, which facilities the quantification of the ischiofemoral distance and the recognition of edema/fat infiltration/tearing of the quadratus femoris muscle. Ultrasound is useful for scrutinizing the integrity of deep gluteal muscles, and its capability to measure the ischiofemoral space is comparable to that of magnetic resonance. Various injection regimens can be applied to treat ischiofemoral impingement syndrome under ultrasound guidance and they appear to be safe and effective. Finally, more randomized controlled trials are needed to build solid bases of evidence on ultrasound-guided interventions in the management of ischiofemoral impingement syndrome.

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How frequent is absolute femoral retroversion in symptomatic patients with cam- and pincer-type femoroacetabular impingement?

Cited by 4 publications

References 61 publications

Proximal femoral derotation osteotomy for management of femoral malversion: a systematic review

Proximal femoral derotation osteotomy for management of femoral malversion: a systematic review

Radiological predictors of outcomes in hip arthroscopy for femoroacetabular impingement

Ischiofemoral Impingement Syndrome: Clinical and Imaging/Guidance Issues with Special Focus on Ultrasonography

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